Open Access Medical Books



Edited by Bruce M. Rothschild .

Open Access .
602 pages .

The inevitability of a disease sounds a clarion for its prevention, or at least its control. Understanding its pathophysiology is essential to that process. For osteoarthritis, preconceived notions and mythology must be transcended to allow identification of its essentials. The first step was to establish a scientific basis for its recognition. Sorting associated phenomenon allowed identification of those which are non-diagnostic, and one major finding which is pathognomonic: the joint osteophyte. Once that was distinguished from the asymptomatic vertebral body, osteophytes identifying spondylosis deformans, a major impediment to disease understanding, was eliminated. While animal models have been sought or manufactured to address the question, this new understanding afforded a new perspective. There is a major dichotomy between the frequency of osteoarthritis in wild-caught and captive animals.
The former were seldom afflicted, while the latter commonly develop osteoarthritis. The commonality with the human condition is the artificiality of the environments that we share to varying degrees. Transformation from an arboreal to a terrestrial habitat, alteration of ground conditions, alteration of gait, and design of footwear are a few of the factors to consider.
This work is divided into sections on the basis of epidemiology, biomechanics, altered morphology and its imaging, biochemistry, immunology, genetic contributions, environmental and sports-related trauma, and quality of life. The question of primacy of cartilage or bone in the induction of osteoarthritis is reviewed, examining also the role of synovial and other extra-osseous, extra-cartilaginous tissues. Recognizing osteoarthritis and alteration in joint morphology and kinesiology and their interactions is explored.
Osteoarthritis has variably been referred to as a non-inflammatory and as an inflammatory form of arthritis. The latter perspective seems to derive from the apparent role of inflammation and immune response in wound healing. Therefore, the role of mediators of healing, inflammation, and modulators of immune response are reviewed. The role of the nervous system in development and progression of osteoarthritis is explored. Absence of certain nerve functions (e.g. position sense) leads to accelerated joint damage (a neuropathic joint), while cholinergic effectors may also contribute to joint damage.
Epidemiological studies afford the opportunity to identify possible factors which mitigate the occurrence or severity of osteoarthritis. Genetic analyses suggest possible vectors and genetic models allow the resultant hypotheses to be tested. Their use obviates the need to create artificial surgical models of disease. The inherent role of joint instability can be directly evaluated, rather than artificially produced instability.
The latter perhaps directly models osteoarthritis related to trauma. Trauma modifies tissue relationships, creating an artificial state which may itself be a major factor in development of osteoarthritis. So, too, it is with sports. Inherent in many sports activities is joint trauma, and training often includes efforts to allow the body to accept more punishment. “Work hardening” may predispose to osteoarthritis, as may injudicious training programs. Optimizing training to increase the rate and level of preparation for sports must be individed. Nonetheless, it carries risk of injury and precipitation of osteoarthritis. The resultant quality of life often reflects the care taken during those life events.
Osteoarthritis is the most common disease affecting humans. It has been suggested that the only reason the entire human population is not afflicted is because we die too soon. As life expectancy is extended, the prevalence of osteoarthritis can be expected to increase. Osteoarthritis appears to be the inevitable result of the human condition, or at least as it exists today. Understanding its nature and contributing factors may allow prevention. Redesign of walking surfaces and initiation of exercise programs oriented to maintenance of joint stability have seen reasonable recommendations to start that process. Understanding the nature and character of osteoarthritis should facilitate its control and perhaps prevention. This book specifically examines opportunities for intervention in the process. Medicinal applications are a subject for a second volume.

Dr. Bruce Rothschild
Professor of Medicine, The Northeastern Ohio Universities, 
College of Medicine,
Director, Arthritis Center NEO,


Part 1 of the Textbook : Overview of Osteoarthritis .

 1 Epidemiology and Biomechanics of Osteoarthritis 3 Bruce M. Rothschild and Robert J. Woods

 2 Symptoms, Signs and Quality of Life (QoL) in Osteoarthritis (OA) 25 Keith K.W. Chan and Ricky W.K. Wu

Part 2 of the Textbook : Osteoarthritis  Imaging .

 3 An Atlas-Based Approach to Study Morphological Differences in Human Femoral Cartilage Between Subjects from Incidence and Progression Cohorts: MRI Data from Osteoarthritis Initiative 43 Hussain Tameem and Usha Sinha

 4 The Application of Imaging in Osteoarthritis 65 Caroline B. Hing, Mark A. Harris, Vivian Ejindu and Nidhi Sofat

 5 Biomarkers and Ultrasound in the Knee Osteoarthrosis Diagnosis 89 Sandra Živanović, Ljiljana Petrović Rackov and Zoran Mijušković

Part 3 of the Textbook : Biomechanics of Osteoarthritis  .

 6 Biomechanics of Physiological and Pathological Bone Structures 113 Anna Nikodem and Krzystof Ścigała

 7 Subchondral Bone in Osteoarthritis 139 David M. Findlay

 8 The Relationship Between Gait Mechanics and Radiographic Disease Severity in Knee Osteoarthritis 155 Ershela L. Sims, Francis J. Keefe, Daniel Schmitt, Virginia B. Kraus, Mathew W. Williams, Tamara Somers, Paul Riordan and Farshid Guilak

 9 Osteoarthritis in Sports and Exercise: Risk Factors and Preventive Strategies 173 Eduard Alentorn-Geli and Lluís Puig Verdié

 10 Post-Traumatic Osteoarthritis: Biologic Approaches to Treatment 233 Sukhwinderjit Lidder and Susan Chubinskaya

Part 4 of the Textbook : Genetics of Osteoarthritis .

 11 The Genetics of Osteoarthritis 263 Antonio Miranda-Duarte

 12 Genetic Association and Linkage Studies in Osteoarthritis 285 Annu Näkki, Minna Männikkö and Janna Saarela

 13 Genetic Mouse Models for Osteoarthritis Research 321 Jie Shen, Meina Wang, Hongting Jin, Erik Sampson and Di Chen

Part 5 of the Textbook : Metabolic .

 14 Cartilage Extracellular Matrix Integrity and OA 337 Chathuraka T. Jayasuriya and Qian Chen

 15 Biochemical Mediators Involved in Cartilage Degradation and the Induction of Pain in Osteoarthritis 367 Michael B. Ellman, Dongyao Yan, Di Chen and Hee-Jeong Im

 16 Proteases and Cartilage Degradation in Osteoarthritis 399 Judith Farley, Valeria M. Dejica and John S. Mort

 17 Simple Method Using Gelatin-Coated Film for Comprehensively Assaying Gelatinase Activity in Synovial Fluid 419 Akihisa Kamataki, Wataru Yoshida, Mutsuko Ishida, Kenya Murakami, Kensuke Ochi and Takashi Sawai

 18 Toll-Like Receptors: At the Intersection of Osteoarthritis Pathology and Pain 429 Qi Wu and James L. Henry

 19 Anion Channels in Osteoarthritic Chondrocytes 445 Elizabeth Perez-Hernandez, Nury Perez-Hernandez, Fidel de la C. Hernandez-Hernandez and Juan B. Kouri-Flores

 20 The Cholinergic System Can Be of Unexpected Importance in Osteoarthritis 461 Sture Forsgren

 21 Transcriptional Regulation of Articular Chondrocyte Function and Its Implication in Osteoarthritis 473 Jinxi Wang, William C. Kramer and John P. Schroeppel

 22 TGF- Action in the Cartilage in Health and Disease 497 Kenneth W. Finnson, Yoon Chi and Anie Philip

Part 6 of the Textbook : Cellular Aspects of Osteoarthritis .

 23 How Important are Innate Immunity Cells in Osteoarthritis Pathology 519 Petya Dimitrova and Nina Ivanovska

 24 The Role of Synovial Macrophages and Macrophage-Produced Mediators in Driving Inflammatory and Destructive Responses in Osteoarthritis 545 Jan Bondeson, Shane Wainwright, Clare Hughes and Bruce Caterson

 25 Cellular Physiology of Articular Cartilage in Health and Disease 567 Peter I. Milner, Robert J. Wilkins and John S. Gibson

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Published by: Unknown - Saturday, June 8, 2013


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